The truth becomes revealed in funny ways sometimes... Ive known for sometime my mother has dementia. At least as far back as when my brother Timmy was terminally ill a few years ago. Thinking back she obviously had dementia for some years prior. She has all sorts of classic symptoms...delusions...paranoia...cognitive dysfunction...memory loss. That last one...memory loss is where it gets interesting. When people think of dementia they commonly think of Alzheimers disease. Some people think the two are synonymous...in fact there are other causes for dementia. In Alzheimers people commonly lose short term memory first. Memory is lost in a reverse timeline. Older memories commonly remain long after recent ones are long gone. It hasnt been that way with my mother. Her long term memory became muddled long before the sort of general memory loss she exhibits now. That isnt typical of Alzheimers...its more typical of another form of dementia...Dementia with Lewy Bodies. Dementia with Lewy Bodies is commonly associated with Parkinsons disease. Ive long suspected my mother has Parkinsons...the stooped posture...shuffling walk...tremors in her hands which have spread to her legs...other things. None of those symptoms in and of themselves are necessarily dispositive...they can be caused by other things. So I could never say with certainty my mother has Parkinsons though I had long suspected it. Until yesterday. It wasnt a dramatic revaluation...say falling as a result of freezing, which happens as the disease progresses. It was much more subtle...but equally indicting. I saw my mother signature on something. Hadnt seen a sample of her handwriting in a long time. Her signature was tiny...with the letters unbelievably close together. Though less well known than the tremors and the expressionless facial mask, that sort of handwriting is a classic Parkinsons symptom. I knew in an instant my mother has Parkinsons...any previous doubt had evaporated. My mother has a doctors appointment on Tuesday. My reaction should be...yay...the doctor will notice the symptoms...send her for some tests...devise a treatment strategy. Except it isnt likely to go like that. Instead her doctor will obsess about her blood sugar...her diabetes is well controlled...and mammograms...colonoscopies. You know...things she lacks specific obvious symptoms for. If she has breast cancer her treatment options are minimal to nonexistent...the risk of the colonoscopy procedure surely out weights the benefits. My mother wont bring up her symptoms...she doesnt want to know...and her purpose in going to the doctor isnt the diagnosis and treatment of symptoms. Her sole purpose is in getting her fix...her coveted prescription for Xanax. Both will play a dishonest game of lets pretend. I could push the issue, but I wont. She isnt likely to agree to go to a neurologist for a proper diagnosis. From her perspective she doesnt need to. She already has an internist to feed her addiction, what does she need a neurologist for. Even with a diagnosis the problem becomes treatment. Treatment for Parkinsons involves copious amounts of medication...medication I doubt her damaged and declining liver could handle. So I am not sure as a practical matter what the point is at this juncture. And so Jane and I will take my mother to the doctor on Tuesday. It will be difficult...frustrating. The doctor will collect his fee...my mother her script. And things will go along as they have...my mother will continue to decline physically...mentally. Her Parkinsons will decline as well. If she lives long enough she will freeze and fall down...that is an inevitable part of the progression of Parkinsons. When...hard to tell. Parkinsons always progresses...in every case...though the rate of that progression varies considerably. And the doctors appointment...it will be a deeply cynical waste of time and money.
Posted on: Sun, 10 Nov 2013 21:40:27 +0000